Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer

Roberts, Kate; Rickett, Kirsty; Vagenas, Dimitrios; Woodward, Natasha

doi:10.1002/14651858.cd012988.pub2

Cited by 37 publications

(45 citation statements)

References 97 publications

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“…The quality of the systematic reviews was mixed. Four systematic reviews had critically low quality [27][28][29][30], nine were low quality [31][32][33][34][35][36][37][38][39], 13 moderate quality [40][41][42][43][44][45][46][47][48][49][50][51][52], and seven high quality [53][54][55][56][57][58][59] (Table 1). There were consistent weaknesses within the reviews.…”

Section: Descriptionmentioning

confidence: 99%

“…The quality assessment ratings for each systematic review are available in Appendix Table S1 and S2. No reviews reported the source of study funding, and pre-registrations and explanations for deviating from protocols was uncommon (six adherent [50,54,[56][57][58][59], one partially adherent [40]). Six reviews failed to disclose author conflicts of interest or how they managed existing conflicts [29,30,32,33,46,48].…”

Section: Descriptionmentioning

confidence: 99%

“…Eight systematic reviews [28,33,39,[47][48][49][50]59] and three clinical guidelines [61,72,73] reported on physical activity as a self-management strategy for arthralgia. One systematic review [59] and one clinical guideline [61] were rated as high quality.…”

Section: Physical Activitymentioning

confidence: 99%

“…This finding was supported by most evidence from the lower quality reviews, particularly those focussed on low intensity interventions such as yoga and Tai-Chi. One large randomised controlled trial was included in all systematic reviews [28,33,39,[47][48][49][50]59] and one of the clinical guidelines [72], and reported supervised aerobic and resistance training could improve arthralgia in this population.…”

Section: Physical Activitymentioning

confidence: 99%

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Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

et al. 2021

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Purpose Side-effects of adjuvant endocrine therapy (AET) are common in breast cancer survivors, and can affect adherence to treatment. We synthesised the evidence for strategies to self-manage these side-effects. Methods We searched for systematic reviews and clinical guidelines on self-management strategies for AET side-effects (arthralgia, fatigue, hot flashes, gastrointestinal discomfort, nausea, vulvovaginal symptoms, and sleep disturbance). We searched oncology organisation’s websites and eight databases (Inception-November 2020). Screening, data extraction and quality assessment were completed independently in duplicate. PROSPERO: 2019CRD4201914001. Results We identified 33 systematic reviews and 18 clinical guidelines. 21% of reviews were high quality, and the average quality score for guidelines was 44%. Evidence for most strategies was absent or weak. There was consensus from a low-quality review and multiple guidelines to recommend moisturisers, gels and lubricants for vulvovaginal symptoms. Evidence was weak for physical activity for self-managing most symptoms, although two high-quality reviews indicated yoga and aerobic exercise could reduce fatigue. Primary research was often biased by weak and underpowered study designs. Eleven reviews did not report information on adverse events. Conclusions Most self-management strategies for breast cancer survivors experiencing side-effects from AET lack evidence. Primary research is needed using high-quality well-powered designs focusing on implementable strategies. Implications for Cancer Survivors Patients and clinicians should be aware that although the risk of harm is low for these self-management strategies, the likelihood of benefit is often unclear. Women should consider moisturisers, gels or lubricants for self-managing vulvovaginal symptoms, and yoga or aerobic exercise for alleviating fatigue.

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Section: Descriptionmentioning

confidence: 99%

Section: Descriptionmentioning

confidence: 99%

Section: Physical Activitymentioning

confidence: 99%

Section: Physical Activitymentioning

confidence: 99%

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Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

et al. 2021

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“…However, a very recent Cochrane review, including seven RCTs for a total of 400 enrolled patients, provided no clear scientific evidence in favor of exercise in BC women with AIA. Criticisms have been raised regarding methodological heterogeneity in many aspects of the considered studies, such as type, frequency, intensity and duration of practices, as well as lacking comparisons with suitable control arms and supervision validations [116]. Finally, among the treatments of AIA based on non-conventional medicine, some interest was dedicated to acupuncture, which is maintained to enhance the endogenous production of opioid peptides and increasing blood flow [117].…”

Section: Non-pharmacological Management Of Ai-associated Arthralgia Imentioning

confidence: 99%

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Tenti

Correale

Cheleschi

et al. 2020

IJMS

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Aromatase inhibitors (AIs) have radically changed the prognosis of hormone receptor positive breast cancer (BC) in post-menopausal women, and are a mainstay of the adjuvant therapy for BC after surgery in place of, or following, Tamoxifen. However, AIs aren’t side effect-free; frequent adverse events involve the musculoskeletal system, in the form of bone loss, AI-associated arthralgia (AIA) syndrome and autoimmune rheumatic diseases. In this narrative review, we reported the main clinical features of these three detrimental conditions, their influence on therapy adherence, the possible underlying molecular mechanisms and the available pharmacological and non-pharmacological treatments. The best-known form is the AIs-induced osteoporosis, whose molecular pathway and therapeutic possibilities were extensively investigated in the last decade. AIA syndrome is a high prevalent joint pain disorder which often determines a premature discontinuation of the therapy. Several points still need to be clarified, as a universally accepted diagnostic definition, the pathogenetic mechanisms and satisfactory management strategies. The association of AIs therapy with autoimmune diseases is of the utmost interest. The related literature has been recently expanded, but many issues remain to be explored, the first being the molecular mechanisms.

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Systemic therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer

Roberts

Adsett

Rickett

et al. 2022

Cochrane Database of Systematic Reviews

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Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer

Abstract: Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer (Review)

Cited by 37 publications

References 97 publications

Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines

Aromatase Inhibitors—Induced Musculoskeletal Disorders: Current Knowledge on Clinical and Molecular Aspects

Systemic therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer

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